“I used OpenEvidence to generate evidence-based discharge instructions,” I told her. “Took less than two minutes. Between that, Doximity’s AI tools, and DAX for ambient scribing, there’s no telling how much time I save in a day compared to a year ago.”
She nodded and told me about using DAX in her reproductive endocrinology practice. Then we got onto what’s coming next. Ambient ordering within a couple of months. Whatever follows that.
We’re both physicians watching this change our daily work in real time. I’m thrilled, and some nights I lie awake wondering what it means for the profession our son might grow up around.
The diagnostic algorithms catch things I might miss. The documentation that used to eat an hour of my evening now takes minutes. I’m not speculating about this; I’m describing my Tuesday.
That same speed changes what a physician is for. A lot of what took me years to learn, a model now does in a second. So I keep asking myself which parts of this job a machine can’t touch, and I want to spend more of my day there.
OpenEvidence can suggest a treatment. It can’t stand in the operating room and hold someone’s hand while they fall asleep for surgery. It can’t look at a frightened patient and say, “I’m glad you’re here. I think we can fix this.”
So I’m trying to give that part more room.
With my older patients especially, I slow down and ask who they are. Where they’ve been, what they’re proud of, what scares them. I hear the same kind of story all the time, where a patient has quietly given up something she loves because of a problem she assumed she had to live with. Most recently it was a woman who’d stopped going fishing, something she’d done her whole life, because she couldn’t get through a morning on the water without leaking. That changed what “better” meant for her, and it changed what I offered.
The treatments I do are rarely one-size-fits-all. What a patient picks has to fit her values, her appetite for risk, the shape of her life. I can’t sort that out from a chart. It takes a real conversation, and the AI handling my notes is what buys me the time for one.
I perform surgery every day, so it’s easy to forget that for the woman on the table, this is one of the biggest days of her year. She deserves a doctor who remembers that, not one half-watching a screen.
And there’s a kind of judgment I don’t know how to hand off. The sense that something’s wrong before the numbers say so. Reading what a patient won’t say out loud. Knowing when the standard protocol doesn’t fit the person in front of me. I built that over years of being in the room, and I don’t think it lives anywhere a model can reach.
As a urogynecologist, I’m not after a lifelong relationship with my patients. I want them better and free to forget me, except maybe when they’re telling a friend that treatment gave them their life back. Getting there still takes everything that makes us human: listening, understanding, caring about one person’s story.
AI won’t replace what passes between two people when one trusts the other with her body and her fear. I think it gives me more time for exactly that.
That’s why I’m more excited than scared.
How are you thinking about AI in your practice? I’d love to hear from other physicians working through it.
]]>My first rotation was geriatrics at the VA hospital. I still remember that first morning: the hum of equipment, the low chatter of nurses, the smell of institutional floors polished to a shine. Within an hour I met Dr. Morris, the attending who would teach me geriatrics and a good deal more.
She welcomed me, gave me a tour, and handed me two assignments. One was to read the novel Water for Elephants. The other was to watch the documentary Young@Heart. I thought it was a strange way to start a medical rotation. Weren’t there charts to review, guidelines to memorize? Dr. Morris had her reasons, and they came clear soon enough.
Water for Elephants tells the story of Jacob, a young man who endures personal tragedy and finds himself as a veterinarian for a traveling circus. His 93-year-old self narrates it from a long-term care facility. Young@Heart is a documentary about a choir of older adults in England who perform rock songs, people whose spirits refuse to be defined by their years.
Dr. Morris didn’t care whether I followed the plots. She wanted me to take in one idea: we are the same people our whole lives long. Our bodies age; inside, we stay who we’ve always been, full of plans and fears and love. My job was to look past the lab results and the imaging and the physical limits, and find the person there. To uncover their story. To honor who they were and who they are.
I’ve carried that since. It’s easy in medicine to get caught up in the churn: problem lists, treatment plans, the constant push for efficiency. Whenever I feel frustrated or disconnected, I go back to Dr. Morris’s words and those two assignments. They’ve become my first principle: find the story. When I’m struggling to connect with a patient, or stuck building a plan, it’s usually because I forgot to.
People call medicine a science, but Dr. Morris showed me it’s still an art. Behind every lab value is a person with a history and a future, someone’s parent or sibling or child. Treatments matter, but the most meaningful thing we do is help patients keep being who they are inside, and live their story as much as they can.
That first rotation shaped me as much as any since. It taught me more than geriatrics or palliative care. It taught me what it means to care for a person, the whole person and not only the body. I’m grateful for the lesson, and grateful to Dr. Morris for an education you don’t get from textbooks.
Whether you work in medicine or not, take the time to find the story. The patient, the colleague, the person across the dinner table, every one of them is carrying an inner narrative. Uncovering it is a gift. Honoring it is a bigger one.
]]>I grew up in a small town in Middle Tennessee and played football until I got hurt and landed in the office of Dr. David Schmidt, a hand surgeon. He was my first close look at what doctors actually do, and it stuck with me.
College didn’t settle the question. I started in biology, switched to chemistry, and spent every spare hour outdoors.
After college I worked for years before I came back to medicine. I worked with Mountain Challenge, traveled through Central America, served as a house parent at the Milton Hershey School, and worked as a development officer at Maryville College. As a pharmaceutical rep for Eli Lilly, I spent my days in OB-GYN offices, which turned out to be my first real pull back toward medicine. None of it was a detour. Each job taught me how to be with people.
I studied for the MCAT, applied to medical school, and graduated from the Via College of Osteopathic Medicine in Blacksburg, Virginia. Then came clinical rotations in Asheville, an OB-GYN residency at Indiana University, and a fellowship at the University of Louisville.
Now I practice in Green Bay. Those years of work and travel weren’t beside the point; they’re how I learned to see the whole person sitting across from me.
]]>In the ten years after college I had several careers. Marketing director. Pharmaceutical rep at Eli Lilly. A stretch traveling through Central America. College fundraiser. House parent. None of it was wasted time. Each job taught me something about who I am and the kind of work I wanted.
The question I kept circling back to wasn’t “What should I do?” It was “Who are my people?”
I got my first answer as a pharma rep, sitting in OBGYN offices. I felt at home there. I liked the people, the rhythm of the work, the way the conversations went. By the time I started medical school in my thirties, I already knew where I was headed.
Training sharpened it. I found I’d rather care for women past their reproductive years. I’d rather operate than deliver babies. And I wanted to help healthy people get their quality of life back, not manage one crisis after another. Urogynecology gave me all three.
Now I’m two months into a new practice in Green Bay, and I’m grateful. This community has been generous with my family, and it’s made me feel I’m in the right place.
My career has never followed a plan. It’s come from paying attention, to myself and to my patients, and trusting where that led. Starting this practice, I feel like someone who found his people.
]]>Pelvic floor disorders affect the muscles, ligaments, and connective tissue that support the pelvic organs. They can lead to urinary incontinence, fecal incontinence, and pelvic organ prolapse [1].
Several studies connect diet and pelvic floor health:
Fiber keeps your bowels regular and helps prevent constipation. Chronic constipation puts pressure on the pelvic floor muscles and can make pelvic floor disorders worse [2]. A diet with plenty of fruits, vegetables, and whole grains supports healthy bowel function.
Hydration matters for your whole body, and the pelvic floor is no exception. Drinking enough fluid helps prevent constipation and keeps urine from getting concentrated, which reduces irritation to the bladder and urethra [3].
Keeping a healthy weight takes pressure off the pelvic floor. Extra weight raises intra-abdominal pressure, which strains the pelvic floor muscles and can bring on or worsen these disorders [4].
A few dietary changes that support pelvic floor function:
A few nutrients stand out for pelvic floor health:
Diet won’t cure pelvic floor disorders on its own, but it helps you manage symptoms and supports your pelvic health overall. A balanced diet, enough water, and attention to a few key nutrients work alongside your other treatments. As with anything medical, talk to your healthcare provider for advice that fits you.
Nygaard I, Barber MD, Burgio KL, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300(11):1311-1316. doi:10.1001/jama.300.11.1311
Markland AD, Palsson O, Goode PS, et al. Association of low dietary intake of fiber and liquids with constipation: evidence from the National Health and Nutrition Examination Survey. Am J Gastroenterol. 2013;108(5):796-803. doi:10.1038/ajg.2013.73
Beetz R. Mild dehydration: a risk factor of urinary tract infection? Eur J Clin Nutr. 2003;57 Suppl 2:S52-S58. doi:10.1038/sj.ejcn.1601902
Subak LL, Wing R, West DS, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360(5):481-490. doi:10.1056/NEJMoa0806375
Gleason JL, Richter HE, Redden DT, Goode PS, Burgio KL, Markland AD. Caffeine and urinary incontinence in US women. Int Urogynecol J. 2013;24(2):295-302. doi:10.1007/s00192-012-1829-5
Parker-Autry CY, Markland AD, Ballard AC, Downs-Gunn D, Richter HE. Vitamin D status in women with pelvic floor disorder symptoms. Int Urogynecol J. 2012;23(12):1699-1705. doi:10.1007/s00192-012-1777-0
Rondanelli M, Faliva MA, Peroni G, et al. Magnesium Supplementation in the Treatment of Restless Legs Syndrome: A Systematic Review. Nutrients. 2021;13(7):2337. doi:10.3390/nu13072337
Marini G, Rinaldi JC, Damasceno DC, Felisbino SL, Rudge MV. Aerobic exercise training and omega-3 supplementation modulate the pelvic floor muscles in the urethral sphincter of diabetic rats. Neurourol Urodyn. 2019;38(7):1881-1891. doi:10.1002/nau.24089
Pelvic floor physical therapy goes well beyond Kegel exercises. It’s a branch of physical therapy that treats the pelvic floor muscles along with how they connect to the rest of your body.
This therapy aims to:
The pelvic floor doesn’t work in isolation. It’s part of a system that includes your core, diaphragm, hips, and spine, and good therapy treats it that way.
Pelvic floor physical therapy can be beneficial for a wide range of conditions, including:
Even if you haven’t been diagnosed with a specific condition, you might benefit from pelvic floor therapy if you experience frequent urination, difficulty emptying your bladder, or discomfort in your pelvic area.
Your first visit will typically involve a thorough evaluation of your pelvic floor function, medical history, and current symptoms. This may include:
Subsequent sessions may include:
Your therapist might also incorporate techniques such as:
The goal is a treatment plan built for you, one that addresses your pelvic floor and how it works with the rest of your body. That tends to produce results that last.
Pelvic floor physical therapy can lead to significant improvements in quality of life. Many patients report:
Results vary, but many women find pelvic floor physical therapy gives them lasting relief and better function.
Pelvic floor physical therapy is a non-invasive option for many common pelvic floor disorders. By treating the root of the problem with care built around you, it can help you regain control and comfort day to day.
If you’re dealing with pelvic floor issues, raise this option with your healthcare provider. It’s more than Kegels. It’s a full approach to pelvic health that can change how you feel every day.
]]>Lambeau holds more than 77,000 fans. If even 30% are women, that’s around 21,000 in the stands. Stress and urge incontinence affect a large share of women, so it’s a safe bet that plenty of them spent part of the game worrying about a hard laugh, a loud cheer, or the line for the restroom. Those worries don’t just interrupt the fun. For some women, they’re the reason the seat stays empty.
Urinary incontinence affects up to 50% of women, whether stress, urge, or mixed. Picture a Packers touchdown, the whole stadium on its feet, and you’re calculating your next bathroom trip instead of cheering. For a lot of women this isn’t a minor annoyance. It pulls them out of social life, and over time it can mean staying home.
Incontinence is common, but it is not a normal part of aging you have to put up with. Urogynecology offers a range of treatments: lifestyle changes, pelvic floor physical therapy, devices you use as needed, and surgery when a lasting fix makes sense. Something on that list works for most women.
Asking for help is how you get those activities back. The Packers game, a long laugh with the people you love, an afternoon out without scouting every restroom. As a urogynecologist, I’ll work through the options with you and find the one that fits your life.
The freedom to cheer for your team at Lambeau, to be part of what your community loves, shouldn’t hinge on a pelvic health problem. If you’ve been sitting these moments out, come talk to a specialist. It’s time to get back in the crowd.
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